Early and late results of total gastrectomy in treatment of advanced adenocarcinoma of the cardia.

Sixty-six patients with advanced adenocarcinoma of the cardia underwent total gastrectomy between 1978 and 1986. The operative morbidity rate was 7.5% and the hospital mortality rate (1 month) was 1.5%. The postoperative 1, 3, 4, and 5 year survival rates were 69%, 30.7%, 20% and 13.8% respectively. The quality of life after surgery was improved. Pathological type, lymph node metastasis, completeness of resection and postoperative chemotherapy were the main factors influencing postoperative survival time. Indications for total gastrectomy and the advantages of transthoracic total gastrectomy are discussed.